MRI评估骶髂关节正常骨髓分布变化辅助诊断强直性脊柱炎
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国家自然科学基金(81701652)


The evaluation of bone marrow distribution changes adjacent to the sacroiliac joints by MRI helps to diagnose ankylosing spondylitis
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    摘要:

    目的:通过对比强直性脊柱炎(ankylosing spondylitis,AS)及不同年龄正常骶髂关节骨髓分布变化情况,从而发现可能致误诊的MRI影像特征。方法:对31例AS患者(14~46岁)及89例(17~87岁)非血清阴性脊柱关节病(seronegative spondy-loarthropathy,SPA)志愿者行骶髂关节MR检查。AS患者分为活动期、慢性期和终末期3组;志愿者按年龄分为<40岁(青少年组)、≥40~60岁(中年组)、≥60岁(老年组)。常规MR扫描结束后分区测量骶髂关节内的黄骨髓分布范围,计算黄骨髓在该区域的百分比(fat faction,FF)。结果:慢性期及终末期AS患者的骶髂关节FF值明显大于活动期患者,差异有统计学意义(P < 0.001);慢性期与终末期AS患者FF值比较,差异无统计学意义(P=0.636)。另外,AS慢性期患者骶髂关节黄骨髓分布与退变骶髂关节比较,差异无统计学意义,但前者通常表现为局限性沉积,后者表现为弥漫分布。随着受试者年龄的增加,骶髂关节内黄骨髓含量逐渐增加;其中中年组与老年组FF值比较,差异无统计学意义(P=0.221);青少年组FF值与中年组、老年组比较,差异均有统计学意义(P均< 0.001)。结论:通过对比研究,可以发现AS患者骶髂关节黄骨髓的分布特点,有助于减少AS的误诊或漏诊。

    Abstract:

    Objective:This study aims to describe the different appearances of bone marrow distribution changes adjacent to the sacroiliac joint in both ankylosing spondylitis(AS) patients and volunteer control without seronegative spondy-loarthropathy(SPA) at different ages,and to highlight the potential MR imaging features that may lead to misdiagnosis. Methods:The study included 31 AS patients aged from 14 to 46 years old and 89 volunteers without SPA aged from 17 to 87 years old. AS patients were divided into 3 groups:active stage AS patients were divided group,chronic stage group and endstage group. Volunteers were divided into three groups according to their age:40 years old(adolescent group),≥40~60 years old(middle-aged group)and ≥60 years old(old group). Distribution of yellow bone marrow in sacroiliac joint was measured after routine MR scanning,and the percentage of yellow bone marrow in sacroiliac joint(fat faction,FF) was calculated. Results:FF value in sacroiliac joint of AS patients in chronic and end-stage was significantly higher than that in active stage,and the differences were was statistically significant(P < 0.001). There was no significant difference in FF between chronic and end-stage(P=0.636). In addition,there was no significant difference in the distribution of yellow bone marrow in sacroiliac joint between patients with AS in chronic stage and volunteers with degenerated sacroiliac joint,but the former usually showed localized deposition,while the latter showed diffuse distribution. With the increase of age,the content of yellow bone marrow in sacroiliac joint increased gradually; there was no significant difference in FF value between middle-aged group and old group(P=0.221); there were significant differences in FF value between adolescent group and middle-aged group or old group(P < 0.001)。Conclusion:By studying the bone marrow distribution changes adjacent to the sacroiliac joints on MRI,it’s helpful to diagnose AS and reduce the misdiagnosis or miss diagnosis.

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蒋 峰,邹月芬,王文涛. MRI评估骶髂关节正常骨髓分布变化辅助诊断强直性脊柱炎[J].南京医科大学学报(自然科学版),2019,(9):1327-1330

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  • 收稿日期:2019-01-31
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  • 在线发布日期: 2019-09-29
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